Alloimmune Monitoring After Islet Transplantation: A Prospective Multicenter Assessment of 25 Recipients

Details

Serval ID
serval:BIB_CAE69405260F
Type
Article: article from journal or magazin.
Collection
Publications
Title
Alloimmune Monitoring After Islet Transplantation: A Prospective Multicenter Assessment of 25 Recipients
Journal
Cell Transplantation
Author(s)
Delaune V., Toso C., Benhamou P. Y., Wojtusciszyn A., Kessler L., Slits F., Demuylder-Mischler S., Pernin N., Lablanche S., Orci L. A., Oldani G., Morel P., Berney T., Lacotte S.
ISSN
0963-6897
Publication state
Published
Issued date
2016
Volume
25
Number
12
Pages
2259-2268
Language
english
Notes
Ef2vh
Times Cited:2
Cited References Count:35
Abstract
Islet transplantation is an effective treatment for selected patients with type 1 diabetes. However, an accurate test still lacks for the early detection of graft rejection. Blood samples were prospectively collected in four university centers (Geneva, Grenoble, Montpellier, and Strasbourg). Peripheral blood mononuclear cells were stimulated with donor splenocytes in the presence of interleukin-2. After 24 h of incubation, interferon-gamma (IFN-gamma) ELISpot analysis was performed. After a total of 5 days of incubation, cell proliferation was assessed by fluorescence-activated cell sorting (FACS) analysis for Ki-67. Immunological events were correlated with adverse metabolic events determined by loss of >= 1 point of beta-score and/or an increased insulin intake Twenty-five patients were analyzed; 14 were recipients of islets alone, and 11 combined with kidney. Overall, 76% (19/25) reached insulin independence at one point during a mean follow-up of 30.7 months. IFN-gamma ELISpot showed no detectable correlation with adverse metabolic events [area under the curve (AUC)= 0.57]. Similarly, cell proliferation analysis showed no detectable correlation with adverse metabolic events (CD3(+)/CD4(+)AUC = 0.54; CD3(+)/CD8(+) AUC = 0.55; CD3(-)/CD56(+) AUC= 0.50). CD3(-)/CD56(+) cell proliferation was significantly higher in patients with combined kidney transplantation versus islet alone (6 months, p= 0.010; 12 months, p= 0.016; and 24 months, p= 0.018). Donor antigen-stimulated IFNI, production and cell proliferation do not predict adverse metabolic events after islet transplantation. This suggests that the volume of transplanted islets is too small to produce a detectable systemic immune response and/or that alloimmune rejection is not the sole reason for the loss of islet graft function.
Keywords
diabetes, islet transplantation, alloimmune monitoring, elispot, cell proliferation, cell transplantation, organ-transplantation, allograft recipients, peripheral-blood, rejection, ligands, nkg2d, graft, incompatibility, alloreactivity
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Create date
14/06/2021 8:58
Last modification date
18/09/2021 5:38
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